Pour Convergence: College Students' Definitions and Free-Poured Volumes of Standard Alcohol Servings.

We examined the correspondence between college students' ( N = 192, 71% women) definitions of free-pours and their free-poured volumes of beer, wine, and liquor. Participants' mean beer definitions and free-pours were positively correlated; participants' mean wine and liquor definitions were larger than their free-pours, which were fairly accurate. Contrary to what the aggregate mean values indicated, fewer than half of the participants accurately free-poured a standard volume of beer, wine, or liquor (37.4%, 35.1%, and 22.2%, respectively) or provided an accurate definition of beer (45.8%); similar to the aggregate data, few participants provided accurate definitions of standard serving of wine (12.2%) or liquor (12.8%) Instead, a majority of participants' definitions and free-pours were well over or under a standard serving. For all three types of alcohol, there was little correspondence between each individual participant's definitions and his or her free-poured volumes. These data suggest analyses of individual data points may provide information important for data collection, prevention, and intervention strategies.

College students' use of energy drinks, social problem-solving, and academic performance.

Energy drink (ED) use among college students to improve academic performance (AP) has skyrocketed. A growing body of literature indicates that the risks associated with ED use may outweigh the perceived benefits. In this study, 486 undergraduates were surveyed on their general substance and ED usage, Social Problem-Solving (SPS) ability, and AP. It was hypothesized that: (1) ED use would be a negative predictor of AP; (2) SPS would be a positive predictor of AP; (3) SPS would be a negative predictor of ED use; and (4) SPS and ED use would account for a significant amount of the variance in AP. A linear multiple regression for AP was conducted, with predictor variables entered in the following order: total drug use, non-ED caffeine use, SPS, and ED use. The overall model was significant and accounted for approximately 7% of the variance in AP. The hypotheses of the study were supported, indicating that ED use may be related to decreased AP, SPS ability may be related to increased AP, or that students with poor AP and less effective SPS skills are more likely to use EDs. Implications of these findings are important for college students and other users of ED products.

The influence of uncertainty and social support on information seeking concerning illicit stimulant use among young adults.

Using the Theory of Motivated Information Management (TMIM) and the concept of desired informational support as a framework, this project examined factors in the information management process young adults employ in potential information seeking about illicit stimulant drug use with members of their social networks. One hundred and seventy-three individuals participated in the study. Results indicated that (a) uncertainty discrepancy and the desire for informational support covaried, and (b) uncertainty discrepancy, anxiety, and outcome expectancy had significant impacts on the efficacy judgments made by individuals with regard to potential information seeking with their social networks about their stimulant drug use. The study thus provides further evidence for the utility of TMIM as a framework for understanding health communication in regard to drug use, and suggests that desired informational support may be a useful addition to the model for this health issue.

Don'T wag the dog: extending the reach of applied behavior analysis.

We argue that the field of behavior analysis would be best served if behavior analysts worked to extend the reach of behavioral services into a more diverse range of settings and with more varied populations, with an emphasis on the establishment of new career opportunities for graduating students. This is not a new proposal, but it is a tall order; it is not difficult to see why many would choose a surer route to gainful employment. Currently, the most fruitful career path for behavior analysts in practice is in the area of autism and developmental disabilities. For the continued growth of the field of behavior analysis, however, it is important to foster new career opportunities for those trained as behavior analysts. Toward this end, we identify several fields that seem well suited to behavior analysts and summarize the training requirements and likely professional outcomes for behavior analysts who pursue education and certification in these fields. These fields require relatively little additional formal training in the hopes of minimizing the response effort necessary for individuals who have already completed a rigorous program of graduate study in behavior analysis.

Incentivizing physical activity using token reinforcement with preschool children.

We combined several single-subject designs to assess the effects of contingent and noncontingent token reinforcement on moderate-to-vigorous physical activity (MVPA) exhibited by 4 preschool-aged children. Higher overall levels and longer bouts of MVPA reliably occurred when tokens were delivered contingent on MVPA for 3 of the 4 children when compared to baseline (no token) and for 2 of the 4 children when compared to noncontingent-token conditions. The present study demonstrated that the delivery of tokens contingent on MVPA can increase and maintain MVPA exhibited by preschool-aged children, resulting in more MVPA than in baseline conditions and conditions in which tokens are awarded without respect to MVPA. These results demonstrate that token economies can be used to increase MVPA and they add to the evidence base supporting the use of token economies to address a range of behavior problems.

Use of Repeated Within-Subject Measures to Assess Infants' Preference for Similar Others.

Research employing single-choice paradigms in which an infant is asked to make a single choice between two puppets suggest that infants show a preference for prosocial others and those who are similar to themselves. However, the extent to which infants' preference for similar others is stable is unknown, as are other factors within the paradigm that may influence infants' choices. The purpose of this study (two experiments, N = 44 infants, aged 8-15 months) was to replicate and extend previous work by including (1) within-subject repeated measures and (2) an experimental manipulation of a plausible demand characteristic. Results for the first-choice trial indicated a majority of the infants did not choose the similar puppet. Results from the within-subject repeated trials also indicated that a majority of the infants did not choose the similar puppet but a majority did choose a puppet from the same side. The experimental manipulation of the demand characteristic showed no effect on infant puppet choices. These results suggest that a closer examination of the single-choice puppet paradigm for assessing infants' social evaluation is warranted. These findings also support recommendations made by others, including publishing null findings, standardizing data collection and reporting methods, and examining individual differences by employing within-subject designs with repeated measures.

Stability of infants' preference for prosocial others: Implications for research based on single-choice paradigms.

Some research suggests infants display a tendency to judge others' prosocial behavior, and in particular, that infants show a strong preference for prosocial others. For example, data from one frequently cited and well-publicized study showed that, after watching a puppet show with three puppets, 74% of infants chose the puppet that "helped" rather than the puppet that "hindered" a third puppet from attaining its goal. The purpose of the current investigation was to replicate these methods and extend them by including a within-subject measure of infant puppet choice across repeated trials to assess the stability of infants' choice. In the current study, 20 infants viewed a puppet show and chose between two puppets (i.e., helper or hinderer) immediately following the puppet show. Although results were similar to previously published work on the first-choice trial (65% of infants chose the helper puppet on the first trial), infants did not consistently choose the helper across trials; several infants demonstrated a side preference, with 9 infants almost exclusively choosing puppets presented on the right or left side. The current investigation addressed limitations of previous research by including a between-subjects (replication) as well as a within-subjects (extension) repeated measure of choice that allowed for the examination of the stability of the choice measure. Our results, particularly in light of other failed replications, raise questions regarding the robustness of infants' preference for prosocial others and the reliability and validity of the single-choice paradigm.

A systematic review of the free-pour assessment: Implications for research, assessment and intervention.

Excessive alcohol consumption is a major concern. Alcohol consumption data are typically collected via self-report questionnaires. However, research has suggested that individuals are unable to identify a standard drink size and that their self-report may be influenced by certain environmental conditions, calling into question the reliability and validity of self-report. The free-pour is an objective measure that may provide a clearer picture of current alcohol consumption trends, individuals' knowledge of standard drink sizes, and accuracy of self-report. This systematic review of existing free-pour assessment methods suggests that individuals are unable to identify and pour standard drink sizes, with the largest discrepancies occurring for liquor and wine pours and pours into larger and wider glasses. Additional variables that appear to influence pouring behavior are gender, pouring location (e.g., home or laboratory), pouring task (e.g., selecting a line or physically pouring), and drinking history; however, additional research is necessary to better understand the effects of these variables on pouring behavior. These findings have important implications for the accuracy of self-report measures, as well as clinical implications for alcohol use screenings, alcohol education courses, and brief interventions for alcohol use. The systematic review concludes with recommendations for practical applications and future research of the free-pour assessment. (PsycINFO Database Record

Changes in smoking status among substance abusers: baseline characteristics and abstinence from alcohol and drugs at 12-month follow-up.

The impact of change in smoking status on 12-month substance abuse (SA) treatment outcomes was examined among an HMO population seeking SA treatment. Of the 749 participants who entered the study at baseline, 649 (86.9%) were retained at the 12-month follow-up. At treatment entry, 395 participants were smokers and 254 were nonsmokers. At 12-month follow-up, 13% of the 395 baseline smokers reported quitting smoking and 12% of the 254 baseline nonsmokers reported starting/relapsing to smoking. Those who quit smoking were less likely to be diagnosed as alcohol dependent compared to those that remained smokers. Those who started/resumed smoking were more likely to be diagnosed as both alcohol and drug dependent at treatment entry compared to all other groups. Total days abstinent from alcohol and illicit drugs was greatest for individuals who quit smoking (adjusted M=310.6) or who were nonsmokers (adjusted M=294.7) and lowest for those who started/resumed smoking (adjusted M=246.6) or remained smokers (adjusted M=258.2), even after controlling for demographic (i.e. age, income), psychosocial (ASI psychiatric severity), and other treatment characteristics (length of treatment stay, prescribed bupropion) that were associated with days abstinent at 12 months. Self-initiated smoking cessation does not appear to be detrimental to SA treatment outcomes, and may be beneficial. Starting/resuming smoking after entering SA treatment may be a clinical marker for individuals at greater risk of relapse. Future studies may want to measure the smoking status of all participants at all time points in order to include this higher-risk group of substance using smokers.

Pathways to chemical dependency treatment for adolescents in an HMO.

This study examines pathways to chemical dependency (CD) treatment for adolescents in a prepaid health plan, including factors influencing treatment referral and access. Data were collected from 419 adolescent CD treatment intakes ages 13 to 18 in a large, private health plan. The study examines predictors of referral from different sources and of mental health treatment prior to CD treatment. Referral patterns, problem severity, and psychiatric comorbidity differed by gender. Being male (p < .05) and higher scores on the Youth Self-Report (YSR) externalizing scale (p < .01) predicted a justice system referral. Using more types of substances predicted referral by medical and mental health providers (p < .05) and self-referral (p < .01). Higher YSR internalizing scores predicted referral from mental health (p < .01) and self-referral (p <.01). Being White versus African American (p < .05) or Latino (p < .01), older (p < .05), and having higher YSR internalizing scores (p < .05), a conduct disorder (p < .01), or a family member with a substance use problem (p < .01) predicted a mental health visit prior to CD intake. The findings raise questions regarding the role of health plans, clinicians, families, schools, and community agencies in referring and treating adolescents with substance use problems. They suggest that improved coordination of care may promote more integrated treatment practices, which could decrease substance use, mental health, and medical problem severity.

Demographic, psychosocial, and personality characteristics of lesbian batterers.

Prevalence of domestic violence (DV) in lesbian and heterosexual relationships appears to be similar. Despite this, few studies have examined factors associated with DV in lesbian relationships, and even fewer have examined characteristics of lesbian batterers. Demographic and psychosocial characteristics and personality traits were examined in 100 lesbians in current relationships (33 Batterers and 67 Nonbatterers). Results indicated that Batterers were more likely to report childhood physical and sexual abuse and higher rates of alcohol problems. Results from the MCMI-III indicated that, after controlling for Debasement and Desirability indices, Batterers were more likely to report aggressive, antisocial, borderline, and paranoid personality traits, and higher alcohol-dependent, drug-dependent, and delusional clinical symptoms compared to Nonbatterers. These results provide support for social learning and psychopathology theoretical models of DV and clinical observations of lesbian batterers, and expand our current DV paradigms to include information about same-sex DV.

Self-initiated tobacco cessation and substance use outcomes among adolescents entering substance use treatment in a managed care organization.

PURPOSE: Adolescents with substance use (SU) problems have high rates of tobacco use, yet SU treatment has historically ignored treatment for tobacco use. Barriers to such efforts include the belief that tobacco cessation could compromise other SU abstinence. This study examines self-initiated tobacco cessation and 12-month alcohol and drug abstinence in adolescents entering SU treatment in a private, managed care organization. RESULTS: Self-initiated tobacco cessation at 6 months, and at both 6 and 12 months, were related to higher odds of drug abstinence but not alcohol abstinence. CONCLUSION: Self-initiated tobacco cessation was not related to poor SU outcomes, and may be important to maintaining drug abstinence. Implementing tobacco cessation efforts in SU treatment can be challenging, but comprised SU outcomes may not be a barrier. The positive associations for drug abstinence and lack of associations for alcohol abstinence could be due to differences in motivation, medical conditions, or to the illicit nature of drug use. Tobacco use has serious long-term health consequences, and tobacco cessation efforts in adolescent SU treatment programs need further research.

Brief report: a comparison of indirect versus experimental strategies for the assessment of pica.

We conducted functional analyses of pica for three individuals with varying levels of intellectual disabilities. In addition, two indirect assessment instruments (the Motivational Assessment Scale [MAS], and the Questions About Behavioral Function [QABF]) were also administered to both the parent and teacher of the child participants. Results of the functional analyses indicated that pica was sensitive to automatic reinforcement. Further, results of both the MAS and QABF also suggested behavioral sensitivity to automatic reinforcement.

Cigarette smoking and long-term alcohol and drug treatment outcomes: a telephone follow-up at five years.

This prospective study examined the relationship between cigarette smoking and five-year substance abuse treatment outcomes. Of 749 individuals who began private outpatient treatment, 598 (80%) were re-interviewed by telephone at five years. At five-year follow-up, 53% reported smoking cigarettes in the prior 30 days. Smokers were less likely to be abstinent from alcohol and drugs in the prior 30 days (48.3% vs. 64.0%), and had higher Addiction Severity Index (ASI) scores in employment, alcohol, drug, psychiatric, and family/social problems; worse self-reported health; and greater self-reported depression. Findings inform understanding of long-term substance abuse treatment outcomes and potential service needs of smokers.

Coping among individuals seeking private chemical dependence treatment: gender differences and impact on length of stay in treatment.

BACKGROUND: Length of stay in treatment and coping skills are both predictive of chemical dependence and abuse treatment outcomes. However, little is known about whether coping strategies are related to length of stay in treatment. Because predictors of length of stay in treatment vary by gender, it also may be reasonable to expect gender differences in coping strategies as well as in the relationship between coping and LOS in treatment. METHODS: We examined gender differences in baseline coping strategies, and coping strategies as predictors of length of stay in treatment, among 747 (433 men, 314 women) individuals who entered chemical dependence and abuse treatment in a private, managed care facility. RESULTS: Women reported using more emotional discharge (behavioral attempts to reduce tension by expression of negative feelings), cognitive avoidance (cognitive attempts to avoid thinking realistically about the problem), resigned acceptance (cognitive attempts to react to the problem by accepting it), and seeking support/guidance (behavioral attempts to seek information, guidance, or support). Gender differences for emotional discharge disappeared after we controlled for depressive symptom and drug problem severities. Greater use of seeking alternative rewards (behavioral attempts to get involved in substitute activities and create new sources of satisfaction), less use of emotional discharge, and older age were significant predictors of longer length of stay, with no gender differences found. CONCLUSIONS: This study provides evidence for identifying and decreasing the use of emotional discharge early in treatment, possibly through the use of intervention strategies such as anger management, cognitive restructuring, or motivational interviewing, as well as encouraging an increase in participation in alternative activities.

Adolescents with substance diagnoses in an HMO: factors associated with medical provider referrals to substance abuse and mental health treatment.

This study examines the factors related to referrals of adolescents with substance use disorders to substance abuse or mental health treatment by their medical providers. Administrative and chart review data from the membership of a large private health maintenance organization (HMO) were collected from a probability sample of 400 adolescents, ages 13-18, who were diagnosed with a substance use disorder in 1999. Logistic regression analyses examined referral to substance abuse treatment and referral to mental health treatment in the aggregate and stratified by gender. Documented use of both alcohol and another illicit drug, and legal problems increased likelihood of referral to substance abuse and mental health treatment, whereas diagnoses of alcohol and marijuana use disorders decreased likelihood of referral to substance abuse treatment. Mental health diagnoses played a limited role in both types of referrals, although specific psychosocial problems were associated with increased likelihood of referrals. Treatment history and location of first mention of problem were significant predictors of referral. There were no gender differences in referral rates to either substance abuse or mental health treatment; however predictors of referral differed by gender. These findings extend our knowledge about factors that influence clinicians' treatment referrals of adolescents with substance abuse diagnoses and have implications for influencing clinician referral behavior within health plans.

Couples therapy at end of life.

This study reports on a preliminary uncontrolled study of a treatment for couples in which one partner is diagnosed with a terminal illness. In this study nine couples, in which one partner was diagnosed with a terminal illness and had less than 18 months to live, were offered eight sessions of couples therapy. Follow-up data were available for six couples. Two patients died during treatment and a third patient moved out of the area prior to completing the follow-up assessment. Significant decreases were seen in the patients' distress about dying and the frequency of partners' worry about their partner dying. Improvements were also seen in relationship quality. While the size of the study precludes generalizing these findings to a larger population, this study supports further exploration of couples therapy as a potentially useful adjunct to end of life care.